Cervical erosion - is a local violation of the integrity of the epithelium covering the cervix with mechanical or inflammatory origin, detected by the naked eye.In fact, erosion of the cervix can justly be called the surface of the wound or ulcer.Often patient (and sometimes some physicians) referred to as "erosion" of any modified portion of the cervix, detected during the inspection.In part, this terminology is justified, as true cervical erosion often translates to another pathology.
Most real erosion of the cervix associated with the pseudo (or ectopia), since both are stages of consistent development of the pathological process.
As mentioned above, erosion - a wound site.And, like any wound, it exists in the cervical mucus short period.As a rule, after one (sometimes two) weeks mucosal injury begins to heal.Most epithelialization occurs correctly, and in the place of true erosion occurs pseudo cervix - is also a modified portion of the cervical epithelium, but withou
To avoid confusion, patients should be aware that erosion - a wound (ulcer) on the cervix, and pseudo - is the process of improper healing, literally - which remains on the neck after the wound is prolonged.
The most significant reason for the appearance on the cervical mucus eroded area include long-infectious inflammation of the vagina, cervix, and mechanical trauma of tissues of the cervix.
Because of the brevity of life, the real erosion of the cervix are diagnosed less frequently (2%) than ectopia.Ectopic cervical cancer are diagnosed in one in five gynecological patient.
If the healing process of cervical erosion was properly and quickly, on the cervix remains no change, and therefore, to establish the true incidence of occurrence of erosion can not be true.Ectopic cervical cancer in the absence of complications is also capable of self-liquidated.
Cervical erosion sometimes there have baby girls, that is, there is also an innate.It occurs due to improper fetal cervical epithelial cell differentiation on flat and cylindrical.Do not overcome puberty girls and on the cervix can appear as a result of the erosion of unstable hormonal levels.As a rule, congenital erosion is manifested clinically and disappear when ovarian hormonal function becomes full, and the cervix is "ripen."
Sometimes congenital erosion require treatment.If they are joined by an inflammatory process, they do not heal themselves without treatment measures.
for physiological reasons, formed erosion of the cervix during pregnancy.Its occurrence is associated with the natural decline in estrogen effect on the mucous membranes of the external genitalia in a reduction of local immunity.
Cervical erosion does not have specific symptoms.All available its clinical manifestations are associated with a poor background, with the assistance of which it was formed.Abnormal discharge in the cervical erosion caused by concomitant infectious inflammation of the vagina (vulvovaginitis or colpitis) or cervix (endocervicitis).
Like any wound, blood, cervical erosion as a result of direct contact with the douching, tampons introduction, instrumental gynecological examination, sexual intercourse.Spotting at the cervical erosion are minor and transient.
Diagnosis of erosion does not cause serious difficulties.It is well visualized at the initial examination in the form of a modified portion on the surface of the cervix.
to confirm primary, delivered during a visual inspection of the diagnosis carried out a detailed study of the structure of erosion using a colposcope and cytological examination of scrapings from the site of the damaged cervical epithelium.
single method of eliminating cervical erosion does not exist.Like any wound surface, it successfully heals itself.But when there is erosion in the zone associated pathological process, self-epithelialization vaginal epithelium does not occur and there is a long-term erosion sometimes increasing in size.The dominant goal of therapy is to eliminate the underlying disease, trigger the development of erosion on the cervix, as well as the restoration of favorable conditions for its epithelialization.
In rare cases where the erosion of the cervix are diagnosed in the acute stage, after the elimination of inflammation accompanying it quickly heals on its own.
Surgical treatment of acute erosion of conduct is not appropriate.However, it is possible, if the therapy is started when the cervix has already formed ectopic and conservative therapeutic measures have not had the desired effect within two months.
Thus, when after a pelvic exam the patient hears the diagnosis of "cervical erosion", most likely, it is not the true erosion, and ectopia of the cervix.
existing Long (more than two weeks), recurrent cervical erosion correlated with a precancerous condition, they require attention, additional diagnostic procedures, as well as the immediate abolition.
reasons for cervical erosion
The cervix is located at the outside is covered with several layers of epithelial cells form flat.The cavity inside the cervical canal is lined with a single layer of cells of columnar epithelium.At the base of the cervical canal is narrowing its physiological - the outer mouth.It is formed of a solid connective tissue cells, to serve as a protective barrier.Plot merger laminated and columnar epithelium is referred to as a "zone of transformation", it is located inside the external os and is not available for easy inspection.
vaginal mucosa is a "target" for the estrogen.With their participation, all the processes of the cell "aging" and updates.Based in part of the vagina is covered by the epithelium of the cervix, the vaginal mucosa identical, therefore, estrogens affect the cervix.That is incorrect estrogenic influence explains the existence of congenital erosions during childhood and adolescence.In fact, congenital cervical erosion is ectopia columnar epithelium of the cervical canal.Unlike the real erosion of the cervix, congenital ectopia is not a wound or ulcer.It is formed because of "slippage" columnar epithelium beyond the external os on the surface of the cervix.Most
like congenital structural disorders disappear on their own, and only a small number of congenital ectopia persist until puberty.
True cervical erosion is disposed around the external os deep defect in the surface epithelium.Under the influence of provoking reasons on a limited section of the cervical surface damage occurs and rejection multilayered epithelium exposing the subject of glands and blood vessels.
According to the reasons of occurrence release:
- Inflammatory cervical erosion.The infectious-inflammatory process in the vagina (colpitis) or cervix (cervicitis) can significantly damage the lining of the cervix and cause it to local rejection.
- Specific erosion of the cervix.Diagnosis is very rare.Its cause is tuberculosis or syphilis.In tuberculosis infection in the cervix gets from other foci hematogenically (the blood vessels).
Genital infections (gonorrhea, trichomoniasis) in a reduction of local immunity also can damage the cervix.
- traumatic cervical erosion.As a rule, it appears after mechanical damage to the cervix during childbirth, abortion, incorrect surgical procedures.In elderly patients injured cervical mucus can cause oppressive royal ring.
- burn erosion of the cervix.After exposure to the neck Leser or chemicals, "cautery" or "freeze" on its surface is formed eschar (scab).It consists of dead skin cells and covers subject to the wound (ulcer).As epithelialization ulcerated surface crust is gradually torn away, revealing a healthy mucosa.Sometimes the healing process takes place properly, and the process of rejection crust happens prematurely when underneath there is still eroded land.
- trophic erosion, which is formed as a result of disruption of the normal power supply covering tissues of the cervix.Diagnosed in women during menopause, on the background of physiological hypoestrogenism.When deletion or loss of the genitals is called erosion dekubitalnoy trophic ulcer.Dekubitalnaya ulcer formed due to the inflection of the blood vessels, where they do not eat the cervix, as well as due to congestive processes in the pelvic cavity.
- cancerous cervical erosion.It is the result of the collapse of cervical cancer or its early stage.
essential role in the development of erosions and ectopias playing local immunity.Patients with reduced immunity to cope with bad infections, and damage to the cervix have much longer to heal.
Inflammatory (non-specific), traumatic, and burn erosion epiteliziruyutsya for one or two weeks independently.Proper healing is due to the erosion of the surrounding multilayered epithelium.Sometimes, however, the surface begins to heal erosive by columnar epithelium of cervical canal, while on the surface of the cervix appears pseudo.Uncomplicated false erosion are sometimes present on the cervix for years without causing adverse effects.
Sometimes true physiological cervical erosion appears unreasonably in healthy women under 25 years, and then self disappears.
Any erosion of the cervix, including congenital, can be complicated by the accession of an infectious inflammation.
More → Causes of cervical erosion
Symptoms and signs of cervical erosion
True cervical erosion there is a long and often not manifest itself so infrequently diagnosed by a doctor.Typically, the process is revealed in the next step when the eroded surface has epitelizovalas, and in its place there was ectopic.
Since conventional wisdom under the term "cervical erosion" refers to several different states, and the diagnosis is very common among patients There is a lot of myths about this disease, you need to consider:
1. If there is bleeding, the patient is the erosion of bloodcervix.Indeed, sometimes complicated by extensive erosion cause the appearance of minor contact bleeding, but they are never heavy and prolonged.
2. Sometimes, feeling pain in the external genitals, patients believe that it hurts cervical erosion.The nerve endings in the cervix is not (otherwise during childbirth woman would die of shock), and erosion really can not get sick.Therefore, "it hurts cervical erosion" Only in the event that infection of the vagina or uterus.
3. Medicinal douching during cervical erosion can cure her.Anti-inflammatory and antibacterial drugs with local action can help eliminate the unfavorable background, but not very erosion.They are used in the form of vaginal suppositories, ointments and appliques.Any independent irrigation during cervical erosion are unacceptable, as they can re-injure the cervix and worsen during erosion.
4. Monthly after cervical erosion (to be exact - after the treatment) are being violated.Status of the cervix does not affect the nature of menstruation, as responsible for the hormonal function of the ovaries.Indeed, the first time after surgical treatment of erosion sometimes appear dark smearing meager allocation associated with the process of rejection of a scab.They can not be correlated with menstruation.Incorrect 'monthly after cervical erosion "are always associated with hormonal dysfunction, which could be the cause of erosion.
5. The best treatment of cervical erosion can be obtained only in the modern (preferably paid) clinic.True erosion quickly heals on its own, but the resulting ectopia cylindrical channel can eliminate lots of not conceding to each other in an effective way.All available therapeutic methods lead to a cure, so the "best treatment of cervical erosion" - is any of them, but appropriate given the patient and carried out by a qualified technician.
6. Cervical erosion is transformed into a malignant tumor.95% erosions never become a cause of cancer.
Complaints patients with erosion caused by concomitant inflammatory diseases of the vagina (colpitis) and cervical (endocervicitis).When complicated by inflammation of the mucous erosion appear or mucopurulent leucorrhea, discomfort.
diagnosis of cervical erosion consists of a small list of successive events.Have any erosion of the doctor can establish by visual inspection.True erosion appears as a bright red sore irregular shape around the external os, a little bleeding when touched.Misleading erosion painted less intensively, because the blood vessels are not exposed, and show through the columnar epithelium.Sometimes erosion is not around the external os, and next to him.
Since the process of irregular cornea ulcer surface is not equivalent, false erosion of the surface and have a different appearance.Simple cervical erosion occurs when the columnar epithelium ulcer closes uniformly, its surface becomes smooth and uniform.If the epithelialization true erosion is accompanied by the formation of papillary excrescences, are classified as papillary ectopia.When viewed from the surface it looks "velvety."Occasionally the columnar epithelium begins to grow deeper, forming microscopic saccular cavity (follicular erosion).Mixed false erosion have signs above ectopia.
Initial inspection reveals only the presence of a defect, or a different color patches on the cervix and put "diagnosis is questionable," and then, using more reliable methods, clarify or refute it.
To determine the cellular composition of any detailed erosion, require laboratory cytology scraping its surface.Cytology is not only ascertains the presence of columnar epithelium, but also reveals signs of inflammation (a large number of white blood cells).Clarify the nature of the infection makes the study of vaginal discharge contents and cervical (Pap "flora", PCR bakposev).
All patients with modified cervix need colposcopy.With the help of an optical device that increases the "picture" about 30 times, the surface of the cervix carefully studied."Suspicious" areas of mucous "pinch off" the special tool (biopsy) and sent for histological examination.The procedure is not accompanied by negative subjective sensations, and does not take much time.
Colposcopic picture of the true erosion is accompanied by signs of inflammation: vasodilation, edema, the presence of inflammatory infiltrates, fibrin deposits and a small amount of blood.Often, on the surface of the ulcer visualized mucopurulent leucorrhea, flowing down the neck of her channel.
To properly diagnose and distinguish true erosion by ectopic simple colposcopy is complemented by special tests:
- sample with acetic acid.After drawing on a modified neck 3% - solution of acetic acid unmodified vessels narrow, the bottom of the real erosion pales.
- Schiller - a cervical staining Lugol solution (iodine solution).Cells were stratified epithelium actively synthesize glycogen.Iodine enters him in a chemical reaction, uniform coloring healthy mucosa in a dark brown color.True erosion does not have a multilayered epithelium, so do not be painted.